Yves Gérard Illouz, inventor of Liposculpture and Dr. José Carlos Daher

Liposculpture presently represents more than 50% of all aesthetic operations performed in the world.

It was initially labeled liposuction since it meant removal of localized fat areas of the body. Following, the fat removed started to be implanted in areas needing filling in for a better contour and thus the name evolved to liposculpture.

This is one of the most fascinating chapters of Plastic Surgery for its contemporary history and revolution, adding a boundless list of new resources and greatly increasing the specialty field of action.

This revolutionary process was casually discovered, as stated by the Frenchman, Yves Gèrard Illouz.

I usually comment that Illouz placed France in the center of the world of Plastic Surgery. In truth, this country was already very developed in the field of plastic surgery by great names related to reconstructive surgery (such as Paul Tessier, for example, a cranio maxillofacial specialist), but without the same notoriety in plastic surgery as by the reputation, the world’s number one, Prof. Ivo Pitanguy of Brazil. It was Illouz that granted this notoriety to France.

Liposculpture is a simple procedure regarding its technical principles, being applicable to most areas of the human body. Through a small skin opening, a tube with a perforation (or multi perforations) is inserted at the tip, sliding over the fat tissue immediately under the skin. This tube is connected to a negative pressure system (a syringe or suction apparatus) which will extract the fat tissue.

It is interesting to note that, not only fat is suctioned, but also part of the fat tissue that carries fat cells, a deposit of this fat.

Therefore, in a remarkable way, the body loses the possibility of selective weight gain in that area, modifying that which is a genetic individual characteristic.

Illouz came upon this process, as he himself reports, when removing lipomas (small benign fatty tumors) from a patient that wished for small scars. From this time on, he evolved to removing larger amounts in different parts of the body.

LIPOSUCTION TECHNIQUE

When first reported, this apparently simple process attracted many unprepared individuals, generating a series of complications which were attributed to the technique itself.

This does not correspond to reality, since this technique is simple but not easy. It proved that it should be applied by well versed Plastic Surgeons, with specialized medical-surgical education and total mastering of the art of Medicine and training in liposuction.

Removal of fat is an easy task, but precise extraction requires specialized expertise and knowledge. Added to this, a support structure is needed such as an anesthesiologist, nurses, equipment, and appropriate facilities to confer maximum safety to the patient. This is the exclusive role of specialists.

This procedure can be carried out on all parts of the body, but with attention to the anatomical characteristics of each area.

Fat injection, or fat implant or lipo implant

The fat removed was automatically scorned. Then we started to inject it into the depressed areas of the body or where we wanted more volume. In the buttocks for example.

Some surgeons were skeptical at first because they felt that the injected fat was absorbed. They later realized that it was partially absorbed, and that another part remained, which was integrated as a living tissue transplanted to the region and even fattened when the patient gained weight. The first place that was consecrated as an excellent recipient of fat implant were the buttocks, that became modelled when removing the handles and flanks while increasing it, resulting in an incredible outcome.  

On the face, for some reason the absorption was greater. We then developed methods of collection and preparation of this fat, and began to make hypercorrections that appeared in the immediate postoperative period, but that evolved in an extraordinary way, after the expected partial absorption.  We have already seen that 45% of the injected fat is incorporated.

Injections of fat on the face have become imperative for the recovery of volumes and contours lost during the aging process. At the same time, it was observed the wonderful results that the fat grafting brings to the texture of the surrounding skin, to the improvement of the scars, etc., etc.

Fat grafts, which has definitively incorporated into the practices of plastic surgery; added to the already consecrated liposuction, creates an absolutely precise and pertinent term: Liposculpture.